SpineEarly Onset Scoliosis Modern Treatment and ResultsTis, John E. MD*; Karlin, Lawrence I. MD†; Akbarnia, Behrooz A. MD‡; Blakemore, Laurel C. MD§; Thompson, George H. MD∥; McCarthy, Richard E. MD¶,#; Tello, Carlos A. MD**; Mendelow, Michael J. MD††; Southern, Edward P. MD‡‡ the Growing Spine Committee of the Scoliosis Research SocietyAuthor Information *Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Bloomberg Children's Center, Baltimore, MD †Department of Orthopaedic Surgery, Harvard Medical School, Children’s Hospital, Boston, MA ‡Department of Orthopaedic Surgery, University of California, San Diego Center for Spinal Disorders, La Jolla, CA §Department of Orthopaedic Surgery, George Washington University, Orthopaedics and Sports Medicine, Children’s National Medical Center, Washington, DC ∥Department of Orthopaedic Surgery, Case-Western Reserve University, Rainbow Babies and Children’s Hospital, Cleveland, OH ¶Departments of Orthopaedics and Neurosurgery, University of Arkansas #Spinal Deformities, Arkansas Children’s Hospital, Little Rock, AR ††Shriners Hospitals for Children, Greenville, South Carolina ‡‡Department of Orthopaedic Surgery, Louisiana State University Health Science Center, Childrens Hospital of New Orleans, LA **Hospital de Pediatria Garrahan, Universidad de Buenos Aires, Buenos Aires, Argentina Thompson GH is the Co-Editor for the Journal of Pediatric Orthopaedics. The other authors declare no conflicts of interest with the present publication.None of the authors received financial support for this study. Reprints: John E. Tis, MD, Department of Orthopaedic Surgery, Johns Hopkins University, Bloomberg Children's Center, 1800 Orleans Street/7356, Baltimore, MD 21287. E-mail: [email protected]. Journal of Pediatric Orthopaedics: October/November 2012 - Volume 32 - Issue 7 - p 647-657 doi: 10.1097/BPO.0b013e3182694f18 Buy Metrics Abstract Background: Early onset scoliosis (EOS) is a potentially fatal, challenging group of diseases the management of which has markedly changed in the last decade. The purpose of this review is to provide the reader with a brief description of each of these new therapeutic modalities, their indications for use, and early clinical results. Methods: A systematic review of peer-reviewed publications and abstracts related to the treatment of EOS in the last decade was carried out and synthesized into a review of modern treatment methods. Results: Recent advances in techniques and understanding of preserving the thoracic space have improved the morbidity and mortality of children with progressive EOS. Derotational casting may be used in younger patients with curves between 25 and 60 degrees. The vertical expandable prosthetic titanium rib is best suited for patients with thoracic insufficiency syndrome. Single or dual growing rods may be used alone or in combination with vertical expandable prosthetic titanium rib to treat patients with progressive EOS who are not candidates for casting. Shilla technique is an alternative to growing rods that avoids the morbidity of repeated lengthenings but is not as well proven as the techniques described above. Other methods such as automatic growing rods and growth modulation techniques are still investigational, and their role needs to be defined after further study. Conclusions: Recent advances have improved the treatment of children with EOS. Treatment continues to be challenging with complication rates higher than treatment of idiopathic scoliosis. Level of Evidence: Level V. © 2012 Lippincott Williams & Wilkins, Inc.